Research on the association between the Chinese visceral adiposity index (CVAI) and hyperuricaemia (HUA) is scarce, and whether the association differs by sex is unclear. This research aimed to explore sex-specific associations between CVAI and HUA and to compare CVAI’s predictive performance with other adiposity indices using data from 22 171 adults (30–79 years) in the China Multi-Ethnic Cohort study (Chongqing region). The prevalence of HUA was 20·9 % in men and 9·7 % in women. Multivariable logistic regression analyses were utilised to assess the adjusted OR and 95 % CI. After multivariable adjustment, CVAI was associated with HUA in men (OR Q4 v. Q1 = 3·31, 95 % CI 2·73, 4·03) and women (OR Q4 v. Q1 = 7·20, 95 % CI 5·12, 10·12). Moreover, significant interactions were observed between BMI and CVAI on HUA in both sexes (all Pinteraction < 0·001), with the strongest associations in those with BMI < 24·0 kg/m2. The OR (95 % CI) across different BMI groups (< 24·0, 24·0–27·9, ≥ 28·0 kg/m²) were 1·87 (1·63, 2·13), 1·65 (1·48, 1·85) and 1·30 (1·14, 1·49) for men and 2·76 (2·18, 3·51), 2·46 (1·98, 3·07) and 1·87 (1·47, 2·39) for women, respectively. Additionally, CVAI showed satisfactory predictive performance for HUA in women, with the largest area under the receiver operating characteristic curve of 0·735, but not in men (0·660). These findings suggest a close association between CVAI and HUA, particularly pronounced in those with BMI < 24·0 kg/m², and a stronger association in women than in men.

Fine particulate matter (PM2·5) is a known risk factor for heart failure (HF), while plant-based dietary patterns may help reduce HF risk. This study examined the combined impact of PM2·5 exposure and a plant-based diet on HF incidence. A total of 190 092 participants from the UK Biobank were included in this study. HF cases were identified through linkage to the UK National Health Services register, with follow-up lasting until October 2022 in England, August 2022 in Scotland and May 2022 in Wales. Annual mean PM2·5 concentration was obtained using a land use regression model, while the healthful plant-based diet index (hPDI) was calculated using the Oxford WebQ tool based on two or more 24-hour dietary assessments of seventeen major food groups. Cox proportional hazard models assessed the associations of PM2·5 and hPDI with HF risk, and interactions were evaluated on additive and multiplicative scales. During a median of 13·4-year follow-up, 4351 HF cases were recorded. Participants in the highest PM2·5 tertile had a 23 % increased HF risk (hazard ratio: 1·23, 95 % CI: 1·14, 1·32) compared with those in the lowest tertile. Moderate or high hPDI was associated with reduced HF risk relative to low hPDI. The lowest HF risk was observed in individuals with high hPDI and low PM2·5 exposure, underscoring the protective role of a plant-based diet, particularly in areas with lower PM2·5 levels. A healthy plant-based diet may mitigate HF risk, especially in populations exposed to lower PM2·5 levels.

High-fat food intake is associated with atopic dermatitis (AD), but the role of habitual dietary habits related to the frequency of high-fat food intake remains unclear. To address this, we developed a frequency-based dietary index, Diet Quality based on Dietary Fat Score, to assess high-fat food intake and examined its association with AD in 13 561 young Chinese adults (mean age = 22·51 years, (sd 5·90)) from Singapore and Malaysia. Using an investigator-administered questionnaire aligned with the validated International Study of Asthma and Allergies in Childhood protocol, we conducted multivariable logistic regression analysis, adjusting for demographics, body mass index, genetic predisposition and lifestyle factors, with false discovery rate correction for multiple comparisons. Frequent high-fat food intake was associated with higher odds of AD (adjusted OR (AOR): 1·53; 95 % CI: 1·31, 1·77; P< 0·001). The association remained significant regardless of total fat intake (AOR: 1·45; 95 % CI: 1·05, 1·80; P< 0·001) and among individuals with high fruit and vegetable intake (AOR: 1·49; 95 % CI: 1·19, 1·86; P< 0·001) or low energy intake (AOR: 1·40; 95 % CI: 1·05, 1·86; P< 0·05). No synergistic effects were observed between dietary factors. These findings highlight that frequent intake of high-fat foods is independently associated with AD, emphasising the potential of dietary moderation in AD risk management.

Dietary intervention is a key strategy for preventing and managing chronic kidney disease (CKD). However, evidence on specific foods’ effects on CKD is limited. This study aims to clarify the impact of various foods on CKD risk. We used two-sample Mendelian randomisation to analyse the causal relationships between the intake of eighteen foods (e.g., cheese, processed meat, poultry, beef and non-oily fish) and CKD risk, as well as estimated glomerular filtration rate (eGFR)cr and eGFRcys levels. The inverse variance weighting method, weighted median method, MR-Egger regression, simple mode and weighted mode were employed. The sensitivity analysis included Cochran’s Q test and the Egger intercept test. According to the main method, the IVM results indicated that frequent alcohol intake was linked to higher CKD risk (P= 0·007, 0·048). Protective factors included cheese (OR = 0·71, (95 % CI: 0·53, 0·94), P= 0·017), tea (OR = 0·66, (95 % CI: 0·43, 1·00), P= 0·048) and dried fruit (OR = 0·78, (95 % CI: 0·63, 0·98), P= 0·033). Oily fish (β = 0·051, (95 % CI: 0·001, 0·102), P= 0·046) and dried fruit (β = 0·082, (95 % CI: 0·016, 0·149), P= 0·014) were associated with elevated eGFRcys. Salad/raw vegetables (β = 0·024, (95 % CI: 0·003, 0·045), P= 0·028) and dried fruit (β = 0·013, (95 % CI: 0·001, 0·031), P= 0·014) were linked to higher eGFRcr, while cereal intake (β = –0·021, (95 % CI: −0·033, −0·010), P < 0·001) was associated with lower eGFRcr. These findings provide insights for optimising dietary strategies for CKD patients.

Many people with rheumatoid arthritis (RA) believe that certain foods may influence disease activity. Elimination reintroduction diets and oral food challenges are dietary strategies used to identify foods that may exacerbate symptoms. This review summarises and appraises the literature on elimination diet interventions that include food reintroductions or oral food challenges in adults with RA. It describes study design, measures used to assess the effects of food exclusion and challenge, foods identified that may affect RA symptoms, and the measures used to assess the outcome of excluding those foods. A search of five databases, two thesis repositories and Open Grey was conducted to identify records published from inception to January 2025, using terms related to RA, elimination diets and food sensitivity. Eligible records were screened independently by two reviewers, and data extraction followed Joanna Briggs Institute guidelines. Data are presented using a narrative synthesis approach with descriptive data analysis. In total, forty-eight records met inclusion criteria comprising twenty intervention studies (sample sizes 4–94) and seventeen case studies, conducted across twelve countries (1949–2024). Interventions included single-food exclusions, few-food diets, low-allergen meal replacements and fasting protocols. Reintroduction methods varied from a single-food challenge to multiple reintroductions, with five studies using blinded challenges. Outcome measures included physician- or participant-observed symptom changes, clinical assessments and laboratory measures, though these were heterogeneous. Findings reveal a lack of standardised protocols, dated methodologies and limited contemporary research. Controlled studies are needed to establish evidence-based protocols, investigate mechanisms, and guide dietary strategies as adjuncts to RA pharmacological treatment.

Despite previous observational studies suggesting that malnutrition could be involved in venous thromboembolism (VTE), definitive causality still lacks high-quality research evidence. This study aims to explore the genetic causal association between malnutrition and VTE. The study was performed using summary statistics from genome-wide association studies for VTE (cases = 23 367; controls = 430 366). SNP associated with exposure was selected based on quality control steps. The primary analysis employed the inverse variance weighted (IVW) method, with additional support from Mendelian randomisation (MR)-Egger, weighted median and weighted mode approaches. MR-Egger, leave-one-SNP-out analysis and MR pleiotropy residual sum and outlier (MR-PRESSO) were used for sensitivity analysis. Cochran’s Q test was used to assess heterogeneity between instrumental variables (IV). IVW suggested that overweight has a positive genetic causal effect on VTE (OR = 1·1344, 95 % CI = 1·056, 1·2186, P < 0·001). No genetic causal effect of malnutrition (IVW: OR = 0·9983, 95 % CI = 0·9593, 1·0388, P = 0·9333) was found on VTE. Cochran’s Q test suggests no possible heterogeneity in both related exposures. The results of the MR-Egger regression suggest that the analysis is not affected by horizontal pleiotropy. The results of the MR-PRESSO suggest that there are no outliers. The results revealed a statistical genetic association where overweight correlates with an increased risk of VTE. Meanwhile, no genetic causal link was observed between malnutrition and VTE. Further research is warranted to deepen our understanding of these associations.

Systems thinking is deeply rooted in history, as far back as Aristotle. However, it has only relatively recently reemerged as an approach to help us understand and intervene in health and food systems. This is particularly salient, given its impact on environmental and population health. Whilst global food is abundant, many people cannot access affordable, healthy and culturally appropriate food. On the other hand, foods of low nutrient density are widely available. Food systems are complex and require complex thinking and approaches that allow us to consider the influence of multiple factors and how the might system respond to change. In turn, this enables the identification of ‘leverage’ points, where policies or interventions are most likely to have a sustained impact. The Foresight obesity map inspired others to adopt systems approaches to help understand the broader social, economic and environmental determinants of obesity to support intervention/policy development. Evaluation of these requires a consideration of complexity to explore why intervention goals may or may not have been successful and how relationships between components or approaches can be enhanced to support implementation and thereby increase the potential for effectiveness. Overall, approaches to understand, intervene, govern and evaluate food systems must themselves be sufficiently complex, or will ultimately be destroyed by the system it seeks to improve. This review paper aims to introduce readers to the application of systems approaches in research within the context of food systems and health, including its traditional/historical origins.

Dietary habits, particularly vegetable consumption, play a crucial role in preventing noncommunicable diseases. However, despite international guidelines advocating daily vegetable intake, adherence remains low across many populations. As a result, more focused efforts to boost vegetable consumption at the population level are essential. This study aimed to assess the impact of a health communication campaign (HCC) in City A, which combined information dissemination and incentives to promote vegetable consumption. In 2021, a new app-based vegetable quiz was introduced as part of the ongoing campaign, which had been implemented since 2017. Participants earned 10 points per correct quiz answer, which could be redeemed for product certificates, with a maximum of 30 points. To evaluate the effectiveness of the quiz, we analysed vegetable intake data from 786 quiz users. A multiple regression analysis was conducted to consider factors such as sex, age, body mass index, pre-campaign points, prior vegetable intake, and frequency of food recording during the campaign. We ensured robustness of the results by analysing data from 605 individuals whose vegetable intake had been tracked one year earlier, during a non-incentivized version of the campaign. The results demonstrated that participants who completed all three quizzes consumed 10.7% more vegetables than non-participants. Year-over-year comparisons further showed a significant increase in vegetable intake among frequent quiz participants compared to the previous year, highlighting the positive impact of gamified quizzes on vegetable consumption. These findings suggest that incentivized HCC, especially those incorporating gamification elements, can be highly effective in encouraging healthier eating habits.

There is mounting interest in the dual health and environmental benefits of plant-based diets. Such diets prioritise whole foods of plant origin and moderate (though occasionally exclude) animal-sourced foods. However, the evidence base on plant-based diets and health outcomes in Australasia is limited and diverse, making it unsuitable for systematic review. This review aimed to assess the current state of play, identify research gaps and suggest good practice recommendations. The consulted evidence base included key studies on plant-based diets and cardiometabolic health or mortality outcomes in Australian and New Zealand adults. Most studies were observational, conducted in Australia, published within the last decade, and relied on a single dietary assessment about 10–30 years ago. Plant-based diets were often examined using categories of vegetarianism, intake of plant or animal protein, or dietary indices. Health outcomes included mortality, type 2 diabetes and insulin resistance, obesity, CVD and metabolic syndrome. While Australia has an emerging and generally favourable evidence base on plant-based diets and health outcomes, New Zealand’s evidence base is still nascent. The lack of similar studies hinders the ability to judge the overall certainty of evidence, which could otherwise inform public health policies and strategies without relying on international studies with unconfirmed applicability. The proportional role of plant- and animal-sourced foods in healthy, sustainable diets in Australasia is an underexplored research area with potentially far-reaching implications, especially concerning nutrient adequacy and the combined health and environmental impacts.

Inflammation and oxidative stress contribute to the progression of chronic diseases, and the volume of research in this area is rapidly expanding. Various dietary indices have been developed to determine the overall inflammatory or oxidative stress potential of a diet; however, few have been validated in cardiometabolic disease populations. This review aimed to explore the association between dietary indices and biomarkers of inflammation and oxidative stress in adults with cardiometabolic conditions. Four databases were systematically searched for literature in any language (Embase, CINAHL, CENTRAL and MEDLINE) with 12,286 deduplicated records identified. Seventeen studies of adults with metabolic syndrome, cardiovascular disease, type 2 diabetes, non-alcoholic fatty liver disease or chronic kidney disease were included. Fourteen studies were observational studies, one study was a clinical trial, and one was a randomised controlled trial. Four dietary indices were reported on with most studies (n 11) reporting on the dietary inflammatory index. The most reported biomarker was C-reactive protein. The findings were narratively synthesised. Results were inconclusive due to the heterogeneity of dietary indices and their use, disease states and biomarkers reported. Only one study reporting on the dietary inflammatory index assessed all 45 parameters. Observational studies, particularly retrospective designs (n 7), are subject to recall and selection biases, potentially presenting overestimated results. Further research is required to determine the relationship between dietary indices and biomarkers of inflammation and oxidative stress in cardiometabolic disease populations. Future research should be prospective, utilise rigorous research methods, assess the full range of index parameters, and examine biomarkers the tool was developed for.

This study elucidated the impacts of coenzyme Q10 (COQ10) supplementation in a high-fat diet (HFD) on growth, lipid metabolism and mitochondrial function in spotted seabass (Lateolabrax maculatus). Totally five diets were formulated: a diet with normal fat content (11 % lipid, NFD), a HFD (17 % lipid) and three additional diets by supplementing 5, 20 or 80 mg/kg of COQ10 to the HFD. After an 8-week culture period, samples were collected and analysed. The results demonstrated that COQ10 inclusion prevented the HFD-induced deterioration of growth performance and feed utilisation. COQ10 alleviated the deposition of saturated fatty acids following HFD intake and promoted the assimilation of n-3 and n-6 PUFA. Moreover, COQ10 administration inhibited the surge in serum transaminase activity and reduced hepatic lipid content following HFD ingestion, which was consistent with the results of oil red O staining. In addition, HFD feeding led to reduced hepatic citrate synthase and succinate dehydrogenase activities and decreased ATP content. Notably, COQ10 administration improved these indices and up-regulated the expression of mitochondrial biogenesis-related genes (pgc-1α, pgc-1β, nrf-1, tfam) and autophagy-related genes (pink1, mul1, atg5). In summary, supplementing 20–80 mg/kg of COQ10 in the HFD promoted growth performance, alleviated hepatic fat accumulation and enhanced liver mitochondrial function in spotted seabass.

Building on the success of the Soft Drinks Industry Levy (SDIL), new tax proposals have been considered in the public health policy debate in the UK. To inform such debate, estimates of the potential impacts of alternative tax scenarios are of critical importance. Using a modelling approach, we studied the effects of two tax scenarios: (1) a hypothetical excise tax designed to tax food products included in the Sugar Reduction Programme (SRP), accounting for pack size to reduce the convenience of purchasing larger quantities at once; (2) an ad valorem tax targeting products based on the UK Nutrient Profile Model (NPM). Simulations of scenario 1 show a reduction in sugar purchased of up to 38 %, with the largest decreases observed for sweet confectionery with a tiered tax, similar in structure to the SDIL. Expected food reformulation in scenario 1 led to further decreases in sugar purchased for all categories. In scenario 2, under the assumption that the tax would not affect purchases of healthier products, a 20 % tax on less healthy products would reduce total sugar purchased by 4·3 % to 14·7 % and total energy by 4·7 % to 14·8 %. Despite some limitations and assumptions, our results suggest that new fiscal policy options hold a significant potential for improving diet quality beyond what has been achieved by the SDIL and SRP. An estimated increase in consumer expenditures in both scenarios suggests that attention needs to be paid to potentially regressive effects in the design of any new food taxes.

Evidence of an association between metabolic syndrome (MetS) and irritable bowel syndrome (IBS) is emerging but is still inconclusive. The current cross-sectional study was conducted to explore the relationship between the two syndromes in a sample of Lebanese adults (n 221; mean age: 43·36 years; 62·9 % females), recruited from a large urban university and its neighbouring community. MetS was diagnosed based on the International Diabetes Federation criteria, and IBS was assessed using the Birmingham IBS scale. Logistic regression analyses were performed taking MetS and its components as dependent variables and IBS and its subscales as independent variables. Covariates included socio-demographic, dietary and lifestyle variables. MetS was positively associated with visual analogue scale (VAS) IBS (total scale (Beta = 4·59, P = 0·029) and VAS–diarrhoea subscale (Beta = 4·96, P = 0·008). Elevated blood pressure (Beta = 5·02, P = 0·007), elevated fasting blood sugar (Beta = 4·19, P = 0·033) and elevated waist circumference (Beta = 5·38, P = 0·010) were positively associated with VAS–Diarrhoea subscale. MetS and IBS were found to be positively associated in a sample of the Lebanese adult population. We suggest that it might be of value to screen for either condition if one of the syndromes exists. Future longitudinal studies are essential to establish a causal relationship between the two syndromes to further understand the commonality related to pathogenesis and explore potential underlying mechanisms.

While reformulation policies are commonly used to incentivise manufacturers to improve the nutrient profile of the foods and beverages they produce, only a few countries have implemented mandatory reformulation policies. This paper aimed to review evidence on the design, implementation challenges and effectiveness of mandatory reformulation policies and compare them to voluntary reformulation policies. The systematic search retrieved seventy-one studies including twelve on mandatory reformulation policies. Most mandatory reformulation policies were aimed at reducing trans-fatty acids or sodium in foods. Overall, mandatory reformulation policies were found to be more effective than voluntary ones in improving dietary intakes. Mandatory policies were implemented when voluntary policies either failed or were found to be insufficient to improve the composition of foods. Typical features of mandatory policies could also improve the design of voluntary policies. Examples include strict but attainable targets and a tight monitoring of compliance.